Organization
CHITTENANGO PHYSICAL THERAPY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE BENOIT (MANAGER)
(315) 510-3372
Entity
Organization
Contact information
Practice address
1398 ROUTE 5 W, CHITTENANGO, NY 13037
(315) 510-3372
(315) 510-3688
Mailing address
1398 ROUTE 5 W, CHITTENANGO, NY 13037
(315) 510-3372
(315) 510-3688
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6312360001
MEDICARE DME
—
01
—
J100000252
PTAN
NY
Enumeration date
07/09/2009
Last updated
08/15/2014
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